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Health and social care challenges explored in south east London Issues Paper


The major challenges facing health and social care in south east London have been outlined in an Issues Paper released by the area’s health commissioners. The document – published to promote dialogue  between the local NHS and the people of south east London -  sets out a number of things that need to change and how organisations across the area are working together to tackle them over the next five years.


The public are being invited to express their views on the issues raised in the document, as well as the strategy that is being developed to resolve them.


Many issues are common across the NHS and some are specific to south east London:


  • Too many people live with preventable ill health or die too early

  • People’s experience of care is variable and can be much better

  • The outcomes from care in our health services vary significantly and high quality care is not available all the time

  • We don’t always treat people early enough to have the best results

  • Patients say that their care is not joined up between different services

  • The social care system is under increasing pressure

  • The money to pay for the NHS is limited and need is continually increasing

  • Every one of us pays for the NHS; we have a responsibility to spend this money well


The strategy, known as Our Healthier South East London, is being led by the six south east London clinical commissioning groups – Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark – and health commissioners from NHS England.


They are working together with local councils, hospitals, mental health, primary and community care services, the six borough Healthwatch organisations, local people and patients to come up with ways to make improvements for everyone.


You can find out more by watching a short video here  and read more here​


The strategy identifies six areas of care as priorities for improvement:​


  • Community based care (such as GPs, community nursing, voluntary and social care)

  • Maternity

  • Children’s and young people’s services

  • Cancer

  • Planned care (treatment arranged in advance)

  • Urgent and emergency care


It also takes an integrated approach to improving mental health, which is considered a core part of each of these six priorities.


Clinical leadership groups – which include patients and members of the public as well as local commissioners, doctors, nurses and therapists, health service managers and social care leaders working for local councils – have been formed to come up with potential solutions for each of the priority areas, and have met several times.


The Issues Paper sets out the challenges in more detail, as well as why some things should change.  It poses some questions for the public to think about and puts forward the current thinking around possible solutions for each of these six areas of care.

Professor John Moxham, Joint Chair of the programme’s Clinical Executive Group* and Director of Clinical Strategy at King's Health Partners Academic Health Sciences Centre, said:

“We want to know what people think about some of the emerging ideas – such as more integration across different services, providing more care in community settings, and supporting people to live healthier and stay out of hospital.

“We’d like people to feed their views back to us, which will help us further progress these ideas and inform the strategy as we continue to develop it.”


Dr Andrew Parson, also Joint Chair of the Clinical Executive Group and Clinical Chair of Bromley CCG, added:


““We need to be much more proactive about keeping people well and helping them to live healthier lives. And we need much better co-ordination of care, so that all the services local people use are working together for them.


“It’s important to build on what works, because we have some very good health services in south east London. People are living longer and many people are healthier than ever before. But this isn’t consistent for everyone. Your experience of healthcare shouldn’t depend on where you access care or on where in south east London you live. We know by spending our limited pot of money differently, we can get better results.”


Dr Marc Rowland, Chair of Lewisham CCG, said: “Here in Lewisham, we face particular challenges around tackling health inequalities and  reducing the numbers of early deaths. We are also aware that some challenges – such as the quality and affordability of services and whether we have the right workforce in place - cut across borough and organisational boundaries. We know we need to work together with neighbouring CCGs  – and across health and social care – to address them.


“We have engaged with our residents about the issues paper at a number of events such as the Phoenix Festival and Dementia Conference and will continue to do so over the summer. It has been received very well so far as people in Lewisham are passionate about health care services in the borough and are very good at telling us what they think. We look forward to working with partners, neighbouring CCGs across south east London and our own residents to tackle the challenges ahead.”


An Issues Paper is not a public consultation document, but bodies which have produced them in the past report that they have helped public engagement and future public consultation, by starting an open dialogue with stakeholders and the public. For this reason, bodies such as The Consultation Institute, who are leading thinkers in the field of public consultation and engagement, recommend the use of issues papers by public sector bodies proposing change. A full public consultation would of course take place if the programme’s discussions led to the development of proposals for major service change.


The Issues Paper can be downloaded from, where you can also submit your views. Printed copies will also be available from hospital sites in south east London and summary versions will be available in pharmacies, GP surgeries and other health and social care settings.


To request a copy, or to ask for other formats or languages, email